Idiopathic Chronic Parotitis: Imaging Findings and Sialendoscopic Response

Abstract

Background/Aims: The purpose of this study was to correlate imaging and sialendoscopic findings to therapeutic response in patients with idiopathic chronic parotitis. Methods: We retrospectively reviewed 122 consecutive sialendoscopies performed in an academic medical center by two surgeons between 2008 and 2013. Forty-one (34%) and 54 (44%) patients were excluded on the basis of having parotid or submandibular sialolith, respectively. Nineteen cases were included in the study with idiopathic chronic parotitis. There was a median follow-up of 5 months. Results: Computed tomography (CT) imaging had a sensitivity and specificity of 80.0 and 71.4%, respectively, for predicting abnormal findings on sialendoscopy, while magnetic resonance imaging (MRI) had 100% accuracy in a small set of cases. In glands with noticeable pathology present on preoperative imaging or sialendoscopy, 11 out of 12 glands (92%) treated experienced symptomatic improvement, while 3 out of 7 glands (43%) without pathology on imaging or endoscopy experienced symptomatic improvement (p = 0.038). Conclusions: Sialendoscopy for the treatment of idiopathic chronic parotid disease can improve pain and swelling with a higher frequency of success in patients with abnormalities noted on endoscopy. CT and MRI have a moderate degree of accuracy in predicting which patients will benefit from therapeutic sialendoscopy.

Sialadenitis without sialolithiasis: Prospective outcomes after sialendoscopy‐assisted salivary duct surgery

“…Most prior studies on sialendoscopic therapies for salivary duct stenosis examined symptoms of gland pain and swelling . The COSS questionnaire used in this study provides an expanded query of sialadenitis‐specific symptoms and demonstrated 15 of 20 symptoms improved after SASDS, including pain frequency, pain severity, tenderness frequency, tenderness severity, swelling frequency during meals, swelling severity during meals, swelling frequency between meals, swelling severity between meals, noticeability by others, embarrassment, xerostomia, too much saliva, ability to speak, ability to chew, and ability to engage in daily activities.…”

“…Vashishta et al showed the majority of endoscopic findings include stenosis or strictures, and general symptom improvement was reported in 88% of 51 patients . Heineman et al showed that 74% of patients with idiopathic parotitis had partial or complete response for symptomatic pain and swelling after sialendoscopy . Both of these studies evaluated general improvement or changes in gland pain and swelling.…”

Eosinophilic sialodochitis: redefinition of ‘allergic parotitis’ and ‘sialodochitis fibrinosa’

“…Definable causes of chronic sialadenitis include Sjögren's syndrome, HIV‐associated diffuse infiltrative lymphocytosis, radioiodine‐induced sialadenitis (Wu et al , ), chronic graft‐versus‐host disease (Drew et al , ), and sarcoidosis. ‘Idiopathic chronic parotitis’, ‘chronic recurrent parotitis’, and ‘juvenile recurrent parotitis’ commonly designate chronic salivary gland inflammation without a definable cause (Baurmash, ; Heineman et al , ). Although these are most likely heterogeneous disorders, their features overlap with ‘eosinophilic sialodochitis’, with a similar average age at presentation for the adult forms, female preponderance, and clinical and radiographic features.…”

Sialendoscopy in treatment of adult chronic recurrent parotitis without sialolithiasis

“…These methods have the potential to control the symptoms in mild cases [8]. However, there are only few studies published on conservative treatment, [1] and the number of studies on the treatment of chronic recurrent parotitis with sialendoscopy is also limited [11,14,15]. Therefore, we performed a prospective study on 49 adult patients with chronic recurrent parotitis to evaluate the efficacy of sialendoscopy with or wihtout a concurrent singledose intraductal corticosteroid.…”